My Opine On Hormone (Replacement) Therapy

A few of you have asked me what I think about hormone (replacement) therapy, also called HRT.

Buckle up. It's a long one… but hopefully one you’re really wondering about.

The menopause allopathic/medical community renamed “hormone replacement therapy” to “hormone therapy” a few years ago, to signal that it’s not a “replacement,” but simply therapy. I’m a sucker for technicalities, so I have to use the right terms.

I’m not going to talk about the evidence or Western science. For a really nice look at this broken down for a layperson, I suggest reading Dr. Jen Gunther’s book the ​Menopause Manifesto.​

As with any medication therapy, there are risks and benefits. Dr. Gunther is great for the allopathic side, but blasts the holistic treatments, so just be prepared for that.

I haven’t found a book that adequately balances both sides yet. I may be writing one someday.

This is my opinion, based on what I know from both the allopathic western perspective, and the Ayurvedic perspective.

As I’ve talked about previously, ​the change from fertility to menopause (e.g, perimenopause) is completely natural​, much like the shift from childhood into fertility (e.g., puberty).

We’re supposed to stop producing estrogen and progesterone in the ovaries, and lose the ability to direct all of our (hormonal) energy towards conceiving babies.

We continue to make these hormones in other tissues post-menopause, at much lower levels.

Women in their 20s and 30s often rely on this extra estrogen instead of tending to their digestive fire (agni) on all levels.

What I mean by this is we rely on estrogen instead of regulating what and how we eat, getting enough rest, getting enough sleep, etc.

Essentially, ​we don’t take care of ourselves on a foundational level​. Part of the reason we can get away with this in youth is that these hormones act as a buffer to the digestive fire of all the tissues.

My mentor Mary Thompson calls this “resting on our estrogen.”

Additionally, sex hormones can be used to make more cortisol (the fight or flight/adrenaline hormone), but cortisol cannot be shunted the other way. It's another way these hormones keep us going under stress.

As our bodies start producing less estrogen and progesterone and we don’t change our ways, SYMPTOMS emerge: fatigue, brain fog, insomnia, hot flushes, vulvar/vaginal issues etc (I’ve discussed this ​here​).

So where does the hormone therapy come in?

Some out there now are saying “You don’t need to suffer! Tell your doctor you want hormone therapy!”

I hate this.

It’s the same as how our society frames other symptoms (or diseases, which this IS NOT). Take this <drug> and you don’t need to change.

Your body is telling you changes need to happen. It’s a wake up call.

If and when you go on hormone therapy, but make no lifestyle changes, then whatever you are not addressing may come back to haunt you in a different way: progressing to things like high cholesterol, high blood pressure, diabetes, and possibly other disease states.

The so-called “diseases of aging.”

It IS all connected. That’s what makes this so difficult to explain.

Now, I am a person who pretty much always believes there is a middle way. Though it may sound like it, I am NOT actually against hormone therapy. In some cases, it might be the ticket: some women really need the support for a while, for various reasons. I have clients on hormone therapy.

Just like other drugs, it’s a tool in our toolkit.

What I am against is taking hormone therapy without examining your life, being really honest with yourself, and bringing the needed changes in over time.